Can oestrogen cream help with urinary tract inflammation?
Vaginal oestrogen cream clearly reduces the risk of recurring urinary tract infections in women after the menopause, and applying it around the urethra works just as well as inserting it deeper. Discuss it with your doctor, as the treatment is not yet officially approved for this purpose everywhere.
Vaginal oestrogen cream substantially reduces the number of recurring urinary tract infections in women after the menopause. Two independent groups of studies reached the same conclusion: the risk of a new infection fell by more than half compared with a dummy treatment. This effect has a clear biological explanation: oestrogen makes the vagina more acidic, which makes it harder for bacteria to survive and reach the bladder.
The way you apply the cream makes little difference. Applying it around the opening of the urethra works just as well as inserting it deep into the vagina. That is welcome news for women who find vaginal application difficult. The internal method does cause itching more often, however: in 24% of women, compared with 2.4% when applying around the urethra. Other possible side effects include irritation, a burning sensation, and occasionally light bleeding or extra discharge.
Oestrogen taken as a pill does not work. Studies involving a total of 2,766 women showed that swallowing oestrogen is no better than a dummy treatment. The substance needs to be applied locally to have an effect.
Whether oestrogen cream works as well as antibiotic courses for preventing infections is not yet clear. The available studies give conflicting results. Some women may find cream alone insufficient and benefit from combining it with other measures. Among non-antibiotic options, vaginal oestrogens and methenamine hippurate (a bladder antiseptic) are considered the best-supported choices.
Despite the positive evidence, the cream is officially approved in most countries only for vaginal symptoms around the menopause, not specifically for preventing urinary tract infections. European and British urologists do recommend it for this purpose. Discuss it with your doctor, who can assess whether it suits your situation and which method of application is most convenient for you.
This answer draws on two large combined analyses, each bringing together multiple studies (one covering five studies with 1,936 participants, one covering seventeen studies with 2,111 participants), supplemented by smaller studies and an overview of non-antibiotic prevention strategies. The evidence for a reduction in infections is consistent and on solid ground. For side effects and the comparison with antibiotics the evidence is thinner: the studies vary and partly contradict one another.
Does vaginal oestrogen therapy do more than just relieve symptoms?
Vaginal oestrogen does more than relieve symptoms: it roughly halves the risk of recurrent urinary tract infections and reduces bladder complaints. Whether it also extends life is unknown; that has never been studied.
Do men need estrogen for their health?
Yes, men need oestrogen for strong bones, healthy blood vessels, and fertility. Both a deficiency and an excess are harmful, so it is a matter of finding the right balance.
Does hormone therapy help women age more healthily?
Hormone therapy relieves menopausal symptoms well and shows positive indications for bones and metabolism, but the effects on the heart and brain are uncertain and highly individual. Whether it is worthwhile for you depends strongly on your symptoms, timing and health history: discuss it with your doctor.
Is hormone therapy during menopause safe and worthwhile?
Hormone therapy works very well against hot flushes and protects bones, but at the same time raises the risk of stroke and blood clots. Whether it is worthwhile and safe for you depends on your personal risk profile, your symptoms, and the form and duration of use: discuss this with your doctor.
Is testosterone important for women?
Testosterone is a physiologically relevant hormone for women, with the strongest evidence for sexual desire and sexual function. If you have symptoms consistent with low testosterone levels, it is worth discussing this with your doctor, including the choice of skin-based delivery.
Can eating too little disrupt your hormones?
Even a temporary, substantial calorie deficit can disrupt sleep and reproductive hormones in healthy women; the timing of your meals also plays an independent role. If you are structurally eating little and experiencing hormonal complaints, that is a good reason to reconsider your eating pattern and potentially discuss it with a doctor.